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dc.contributor.authorLi, Sherly X
dc.contributor.authorMilne, Roger L
dc.contributor.authorNguyen-Dumont, Tú
dc.contributor.authorEnglish, Dallas R
dc.contributor.authorGiles, Graham G
dc.contributor.authorSouthey, Melissa C
dc.contributor.authorAntoniou, Antonis C
dc.contributor.authorLee, Andrew
dc.contributor.authorWinship, Ingrid
dc.contributor.authorHopper, John L
dc.contributor.authorTerry, Mary Beth
dc.contributor.authorMacInnis, Robert J
dc.date.accessioned2022-01-05T16:34:00Z
dc.date.available2022-01-05T16:34:00Z
dc.date.issued2021-10-16
dc.identifier.issn2072-6694
dc.identifier.otherPMC8534072
dc.identifier.other34680343
dc.identifier.urihttps://www.repository.cam.ac.uk/handle/1810/332092
dc.description.abstractProspective validation of risk models is needed to assess their clinical utility, particularly over the longer term. We evaluated the performance of six commonly used breast cancer risk models (IBIS, BOADICEA, BRCAPRO, BRCAPRO-BCRAT, BCRAT, and iCARE-lit). 15-year risk scores were estimated using lifestyle factors and family history measures from 7608 women in the Melbourne Collaborative Cohort Study who were aged 50-65 years and unaffected at commencement of follow-up two (conducted in 2003-2007), of whom 351 subsequently developed breast cancer. Risk discrimination was assessed using the C-statistic and calibration using the expected/observed number of incident cases across the spectrum of risk by age group (50-54, 55-59, 60-65 years) and family history of breast cancer. C-statistics were higher for BOADICEA (0.59, 95% confidence interval (CI) 0.56-0.62) and IBIS (0.57, 95% CI 0.54-0.61) than the other models (p-difference ≤ 0.04). No model except BOADICEA calibrated well across the spectrum of 15-year risk (p-value < 0.03). The performance of BOADICEA and IBIS was similar across age groups and for women with or without a family history. For middle-aged Australian women, BOADICEA and IBIS had the highest discriminatory accuracy of the six risk models, but apart from BOADICEA, no model was well-calibrated across the risk spectrum.
dc.description.sponsorshipThis work was primarily supported by grant 1129136 from the Australian National Health and Medical Research Council (NHMRC) (https://www.nhmrc.gov.au/). MCCS cohort recruitment was funded by Cancer Council Victoria (https://www.cancervic.org.au/) and VicHealth (https://www.vichealth.vic.gov.au/). The MCCS was further supported by Australian NHMRC grants 209057, 396414 and 1074383, and ongoing follow-up and data management has been funded by Cancer Council Victoria since 1995. Cases and their vital status were ascertained through the Victorian Cancer Registry and the Australian Institute of Health and Welfare, including the National Death Index and the Australian Cancer Database.TN-D is a recipient of a Career Development Fellowship from the National Breast Cancer Foundation (Australia). JLH and MCS are Senior Principal and Senior Research Fellows of the National Health and Medical Research Council (Australia), respectively. ACA and AJL are supported by grants from Cancer Research UK (C12292/A20861 and PPRPGM19 Nov20\100002).
dc.languageeng
dc.publisherMDPI AG
dc.rightsAttribution 4.0 International
dc.rights.urihttps://creativecommons.org/licenses/by/4.0/
dc.sourceessn: 2072-6694
dc.sourcenlmid: 101526829
dc.subjectDiscrimination
dc.subjectBreast cancer
dc.subjectcalibration
dc.subjectRisk Model
dc.titleProspective Evaluation over 15 Years of Six Breast Cancer Risk Models.
dc.typeArticle
dc.date.updated2022-01-05T16:34:00Z
prism.issueIdentifier20
prism.publicationNameCancers (Basel)
prism.volume13
dc.identifier.doi10.17863/CAM.79539
dcterms.dateAccepted2021-10-13
rioxxterms.versionofrecord10.3390/cancers13205194
rioxxterms.versionVoR
rioxxterms.licenseref.urihttps://creativecommons.org/licenses/by/4.0/
dc.contributor.orcidLi, Sherly X [0000-0002-7840-4051]
dc.contributor.orcidNguyen-Dumont, Tú [0000-0002-6217-0182]
dc.contributor.orcidEnglish, Dallas R [0000-0001-7828-8188]
dc.contributor.orcidAntoniou, Antonis C [0000-0001-9223-3116]
dc.contributor.orcidMacInnis, Robert J [0000-0002-1627-5047]
dc.identifier.eissn2072-6694
pubs.funder-project-idCancer Research UK (20861)
pubs.funder-project-idCancer Research UK (C12292/A31369)
cam.issuedOnline2021-10-16


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Attribution 4.0 International
Except where otherwise noted, this item's licence is described as Attribution 4.0 International